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P McKinney

Publications and source records attributed to P McKinney.

15 recordsLinked to original sources
PubMed1992

Silicone implants.

Explore the source record for details and available documents.

Ethics, Medical↗
PubMed1991

Criteria for the forehead lift.

We have developed clinically useful measurements to assist the surgeon in deciding when to do the forehead lift and where to place the incision. Also, we have reviewed our experience over the past decade and discuss the four categories and applications of forehead lifts. We use three indications for forehead lift: ptosis, creases, and previous facelift (PCP). There are four basic surgical techniques applicable to the upper face: (1) direct browlift, (2) midforehead crease incision, (3) prehairline incision, and (4) posthairline incision. We determined more accurate guidelines from measurements taken on 50 volunteers, as well as patients seeking a facelift. The line of measurement in a vertical plane extends from the midpupil to the top of the eyebrow and up to the hairline. We have found that the normal distance from the midpupil to the upper edge of the eyebrow on average is 2.5 cm and that the distance from the upper edge of the eyebrow to the hairline is approximately 5 cm on average. If the distance from pupil to brow is less than 2.5 cm, then the patient may benefit from a forehead lift. If the distance from brow to hairline is less than 5 cm, then we use a posthairline incision in females. If this same distance is greater than 5 cm in females, we advise the prehairline incision. In male patients we strongly consider direct crease incision. The direct browlift is reserved for minimal ptosis, asymmetry, or patients who wish a minimal procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

The fourth option: a novel approach to lower-lid blepharoplasty.

Three basic surgical techniques exist for lower-lid blepharoplasty: (1) the skin flap, (2) the transconjunctival approach, and (3) the skin-muscle flap. Each addresses the problems of excessive skin, muscle, and infraorbital fat either alone or in combination. None of these procedures will correct fine wrinkles. In fact, in some patients the lower-lid wrinkling appears far worse after fat removal. We describe a "fourth option" to lower-lid blepharoplasty which corrects the problem of fine wrinkling, periorbital fat herniation, and mild skin excess. For these patients, we remove the fat through a transconjunctival approach and peel the lower lid using full-strength Baker's phenol solution. To date, we have performed this procedure in 17 patients with excellent results. There have been no complications. Our longest followup is 30 months. This procedure is indicated for patients with both excess infraorbital fat and lower-lid skin with associated fine wrinkling. Only the experienced surgeon should attempt this procedure. Caution should be exercised with patients who have previously undergone blepharoplasty as severe ectropion has been reported with chemical peel around the eyelids. Lower-lid chemical peel after a modified skin-muscle flap has been described, but we believe that peeling after a transconjunctival approach is safer. We feel that with more knowledge and experience using the "fourth option" of lower-lid blepharoplasty, it will become the procedure of choice for select patients.

Adult↗
PubMed1989

Liposuction and the treatment of nasolabial folds.

We investigate whether the application of liposuction to the nasolabial region is a useful adjunct to the rhytidectomy procedure. We have devised a system to grade the severity of the depth and the length of the nasolabial folds pre- and postoperatively. This grading system was used to evaluate the nasolabial region in 60 consecutive patients who underwent rhytidectomy. We compared two subgroups: those who underwent rhytidectomy alone (Group I) and those who underwent rhytidectomy augmented by liposuction in the region of the nasolabial folds (Group II). A change in the length of the fold occurred in 2% of Group I and in 30% of Group II. A change in depth of the fold occurred in 12% of Group I and in 70% of Group II. These results suggest that suction-assisted lipectomy consistently improves the results of rhytidectomy in the region of the nasolabial fold.

Female↗
PubMed1989

Occult breast carcinoma in patients undergoing reduction mammaplasty.

Seven patients who had breast reduction surgery and whose preoperative physical examinations were unremarkable were found to have breast carcinoma. In the five in whom mastectomy was performed, most closures were difficult, and in one patient bilateral mastectomy was complicated by wound dehiscence. In only one of these seven was it possible to obtain information regarding the hormonal binding status of the tumor cells. These and other sequelae would not have occurred had the tumors been diagnosed before operation. Because physical examination alone is not sufficiently sensitive for the diagnosis of breast cancer, we suggest that mammography be included in the evaluation of patients consulting surgeons for breast reduction.

Adult↗
PubMed1989

The value of tear film breakup and Schirmer's tests in preoperative blepharoplasty evaluation.

The results of tear film breakup (BUT) and Schirmer's I and II tests were retrospectively analyzed on 146 patients undergoing elective blepharoplasty over a 41-month period. These tests were evaluated in conjunction with ocular history, orbital and periorbital anatomy, and Bell's phenomenon in order to determine their value, if any, in identifying patients at risk of developing a post-blepharoplasty dry eye complication. One-hundred and six patients (73 percent) had test results that were within normal limits, and two of these patients (1.9 percent) complained postoperatively of a transient gritty or burning sensation. Forty patients (27 percent) had abnormal results to one, two, or all three tests, and two of these patients (5 percent) also complained postoperatively of a transient gritty or burning sensation. These four symptomatic patients all had preoperative dry eye histories and abnormal orbital and periorbital anatomy. When analyzed alone, an abnormal tear film breakup (BUT) or Schirmer's test was not a good predictor of possible postblepharoplasty dry eye complications. An abnormal preoperative ocular history or abnormal orbital and periorbital anatomy proved to be the best predictor for the possible development of a postblepharoplasty dry eye complication.

Dry Eye Syndromes↗
PubMed1979

Straightening the twisted nose.

For correction of the twisted nose, the use of a dorsal onlay cartilage graft, obtained from the resected septum, produces the illusion of a straight nose. This persists in spite of any recurrences of deviations in the septum or upper lateral cartilages.

Cartilage↗
PubMed1978

Nasal tip cartilage grafts.

Grafts of autogenous cartilage were utilized in 88 patients to augment the nasal spine, to add definition to the columella, or to support the feet of the crurae when the tip is raised. Complications were uncommon. This technique is an extremely useful adjunct when changing tip profile.

Cartilage↗
PubMed1977

Use of tarsal plate resection in blepharoplasty on atonic lower lids.

We did blepharoplasties with tarsal plate resections on 24 lower lids in 13 patients, two of whom had an established ectropion and 11 of whom had a tendency to a lax ectropion. No ectropion developed in these high risk patients. The tarsal plate resection may be useful for an established atonic ectropion, or in a primary blepharoplasty or in secondary blepharoplasty patients with atonic lower lids. It should not cause detectable scarring.

Adult↗